DEPARTMENT OF VETERANS AFFAIRS

VA Southern Nevada Healthcare System

P.O. Box 360001

North Las Vegas, Nevada 89036

(702) 636-3000

Welcome to the Department of Veterans Affairs,

I am Dr. D’Brot, the Acting Associate Chief of Staff for Education, here at the VA Southern Nevada Healthcare System (VASNHS). Thank you for allowing us the opportunity to participate in your educational experience. We look forward to working side by side with you during your training and we hope to make your rotation here pleasurable and an excellent learning opportunity.

In preparation for your rotation with us, there are a number of forms and procedures that must be accomplished prior to your arrival. The instructions below must be followed fully and specifically. Unfortunately, failure to meet any of these requirements will result in cancellation of your rotation at the VA for that particular month but may at your programs discretion be rescheduled.

Instructions for All Trainees: Do not schedule an appointment for fingerprints or register in the Talent Management System (TMS) until you have a confirmed position with the VASNHS.

Please make sure you return the requirements below to me three weeks prior to your start date.

Make sure you have a printer available. Some of these forms cannot be saved.

1.  Complete the Application for Health Professions Trainees – VA Form 10-2850D.

2.  Read the Medical Center Memorandum-QM-03 Confidentiality of Quality Management Document. Sign and have witnessed the last page.

3.  Complete the Declaration for Federal Employment form (OF-306).

4.  Complete the Trainee Emergency Contact Information form.

5.  Complete the PIV Badge – Required Information form.

6.  Complete the VHA Mandatory Training for Trainees via VA Talent Management System.

7.  Complete the Residents Prescribing Privileges form (if applicable).

8.  Report to VA Human Resources no later than three weeks prior to the start date for fingerprinting. Address: Rancho Courtyard, 1127 South Rancho Drive, Las Vegas, NV 89102. This location is directly behind the Chevron gas station on the corner of South Rancho Drive and West Charleston Blvd. You must call 702-754-5033 or 702-754-5012 to make an appointment. Hours Monday-Friday 8:00AM - 3:00PM.

Thank you all for your cooperation. I am available for questions or concerns via my contact information below.

Juan M. D’Brot, MD, MPH, MBA

Acting Associate Chief of Staff for Education

Telephone: (702) 791-9000 ext 19463

Mobile: (702) 622-7624

Fax: (702) 676-1130